8 Ways to Get More Shut-Eye With Rheumatoid Arthritis

There's no doubt that the better you sleep, the better you feel come morning and all day long — and that may be especially true if you're one of the 1.3 million U.S. adults with rheumatoid arthritis. In a 2011 study, researchers from the University of Pittsburgh's School of Nursing questioned 162 people with RA and found that most reported they were more fatigued and had more severe pain during the day when they didn't sleep well the night before. Nearly two-thirds reported they were poor sleepers, and one-third reported they awoke in pain at least three times a week. They also were more depressed when they lacked sleep, and they couldn't perform as well during the day. Many people with rheumatoid arthritis not only have trouble sleeping, but are also stiff when they wake in the morning, says Scott Zashin, MD, a rheumatologist in Dallas and author of Arthritis Without Pain. If your rheumatoid arthritis is keeping you up nights and making your mornings miserable, the following tips can help.

Follow Through With an Exercise Plan

As hard as it may be to exercise when you have joint pain, you can limit the muscle loss associated with rheumatoid arthritis, reduce heart health risks, and sleep better at night if you exercise during the day. If you have a lot of joint pain and feel fatigued, spread out daily exercise goals into short sessions. “Try to exercise earlier in the day versus late at night,” Dr. Zashin says. Exercise releases endorphins, or feel-good hormones, and it can be hard to fall asleep when you're still on an exercise high.

Skip the Stimulants

You probably know that coffee can keep you up at night or prevent deep sleep. But java isn’t the only source of caffeine in the average diet — you may find that eating sweets close to bedtime keeps you up at night or that the soothing green tea you’re sipping is actually chock-full of caffeine. Figure out which of your favorite foods and beverages could be stealing your sleep and avoid them as much as you can. Also, don’t consume a large meal close to bedtime. It’s harder to sleep on a full stomach and, if you drink too much, you’ll have to get up to go to the bathroom, forcing you to deal with RA stiffness and joint pain at 3 a.m. — and making it that much harder to fall back asleep.

Establish an Evening Ritual

You will sleep better when you go to bed and get up at the same time every day, even if you don’t have to go to work in the morning, Zashin says. Find what relaxes you and make this get-ready-for-bed routine part of your rheumatoid arthritis treatment — it might be a warm bath or shower, or snuggling under an electric blanket. If you set a timer to automatically turn off the blanket, turn it back on when your alarm goes off in the morning and let it warm you for a few minutes before you get out of bed.

Time Your Meds

According to the University of Pittsburgh study, people taking the corticosteroid prednisone as part of their rheumatoid arthritis treatment reported more sleep troubles. If you’ve been prescribed this drug, says Zashin, “you may be better off taking it in the morning and at the lowest dose possible that still helps manage your symptoms.” To help manage rheumatoid arthritis pain and stiffness, talk to your doctor about using long-acting non-steroidal anti-inflammatory drugs (NSAIDs), which didn’t show any negative effect on sleep in the study. “If you take those later in the evening, they might help you feel better in the morning,” adds Zashin.

Try Self-Massage

A recent study by researchers in the department of kinesiology at McMaster University in Hamilton, Ontario, Canada, found that just 10 minutes of massage can help reduce the inflammation that causes muscle pain, and inflammation is part of the rheumatoid arthritis process. A 10-minute massage before bed can also help you sleep. First apply heat to warm your muscles, and then stroke your joints, rubbing back and forth across the muscles with pressure. One caution: Stop if it causes you any pain — joint pain or otherwise.

Consider Sleep Aids

A multi-center study found that almost half the rheumatoid arthritis patients who took the prescription sleeping pill eszopiclone (Lunesta) had no insomnia after four weeks. But prescription sleep aids should be a last resort in your rheumatoid arthritis treatment because they can make you drowsy during the day and can be addictive, says David Silver, MD, a rheumatologist and internist at Cedars-Sinai Medical Center in Los Angeles.

Investigate Other Causes of Sleep Trouble

Your insomnia could be caused by a factor other than your rheumatoid arthritis. For example, Dr. Silver notes that waking up three to four times a night to go to the bathroom could be a sign of prostate issues. Sleep apnea is another condition that can disturb your sleep. Talk to your doctor about ways to investigate other causes of poor sleep — once you know what else is behind it, you can take specific steps to treat it.

Establish a Morning Ritual

Even with restful sleep, one of the hallmarks of rheumatoid arthritis is stiffness upon waking, so ease into your day before you get out of bed. Experiment to see what works best for you: If you’re usually stiff when you wake up, factor in the amount of time it takes you to move freely and set your alarm accordingly. “If you can’t be out of the house in 30 minutes, plan so you can take the extra time you need,” Silver says. Some people find mornings easier if they keep their rheumatoid arthritis medications on their nightstand and take them as soon as they wake up, though this works better if you don’t need to take them with food. Once you’re up and in the bathroom, try running your hands under warm water for a few minutes to help relieve stiffness; massaging them, too, may help. Remembering these gentle self-care steps every day should brighten your morning mood.

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